Objective: To determine whether Parkinson’s disease patients with mild cognitive impairment (PD-MCI) demonstrate more accurate self-appraisals of their cognitive deficits than non-PD individuals with amnestic MCI (a-MCI) or non-amnestic MCI (na-MCI).

Background: A diagnosis of mild cognitive impairment (MCI) often starts with cognitive concerns raised by the patient or a caregiver although, in the context of a brief clinic visit, it can be difficult to ascertain how aware patients may be of their own cognitive deficits. To date the accuracy of self-appraisal in PD-MCI patients has received much less attention than a-MCI associated with Alzheimer’s disease (AD).

Methods: This cross-sectional cohort study included, 30 PD-MCI, 33 a-MCI, and 17 na-MCI subjects.  Self-appraisal was assessed by comparing responses of caregivers and patients on a validated self-rating questionnaire of functional impairments. Positive scores indicated that caregivers reported greater impairment than patients (likely poor awareness of impairment) whereas negative scores indicated that patients reported greater impairment than caregivers (likely exaggerated awareness of impairment). All subjects completed a full neuropsychological evaluation and depression screening measure. Univariate ANOVA, regression, and correlational analyses were employed to identify group differences in anosognosia scores and relationships between cognitive and functional impairment, depression measures, and anosognosia scores.

Results: Self-appraisal accuracy for PD-MCI did not differ significantly from either the a-MCI and na-MCI groups. In the PD-MCI group, higher depression scores were predictive of exaggerated awareness of deficit. In the a-MCI group deficits in executive function correlated with exaggerated awareness of deficit.

Conclusions: Our findings suggest that impaired patient self-appraisal of functional difficulties is equally likely to occur in PD-MCI as in a-MCI and na-MCI patients. Among MCI-PD subjects, depression is the strongest predictor for the severity of impaired patient self-appraisal.  Impaired insight into cognitive impairment should be considered in both clinical care and research with PD patients.

References: Migliorelli R, Tesón A, Sabe L, Petracca G, Petracchi M, Leiguarda R,Starkstein SE. Anosognosia in Alzheimer’s disease: a study of associated factors.J Neuropsychiatry Clin Neurosci. 1995 Summer;7(3):338-44.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/lack-of-accurate-self-appraisal-is-equally-likely-in-mild-cognitive-impairment-from-parkinsons-disease-and-other-neurodegenerative-disorders/